新的抗逆转录病毒抑制剂和HIV-1耐药性:更多关注90%的HIV-1分离株?

IF 10.1 2区 生物学 Q1 MICROBIOLOGY
Emmanuel Ndashimye, Paul S Reyes, Eric J Arts
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引用次数: 0

摘要

联合HIV抗逆转录病毒疗法(cART)是有效的,除非出现耐药性。随着cART在低收入国家的推广,由于最初使用这些耐受性较差的cART方案、药物供应间歇性中断和治疗监测不足等因素,耐药性的出现率高于高收入国家。与主要感染高收入国家(3700万感染者中只有10%)的HIV-1 B亚型相比,不同的HIV-1非B亚型的病毒机制差异加剧了这些影响耐药性的社会经济因素。这篇综述比较了不同HIV-1亚型和菌株对临床试验中批准的各种药物以及新型抑制剂的抑制和耐药性。HIV-1亚型之间的初始序列变异和复制适应度的差异推动菌株通过不同的适应度景观来逃避药物选择压力。这里的讨论为患者护理人员和政策制定者提供了关于如何最好地使用目前批准的抗逆转录病毒疗法选项并减少约3300万感染HIV-1亚型A、C、D、G和重组体形式的人出现耐药性的见解。不幸的是,超过98%的关于cART耐药性的文献与HIV-1亚型B有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
New antiretroviral inhibitors and HIV-1 drug resistance: more focus on 90% HIV-1 isolates?

Combined HIV antiretroviral therapy (cART) has been effective except if drug resistance emerges. As cART has been rolled out in low-income countries, drug resistance has emerged at higher rates than observed in high income countries due to factors including initial use of these less tolerated cART regimens, intermittent disruptions in drug supply, and insufficient treatment monitoring. These socioeconomic factors impacting drug resistance are compounded by viral mechanistic differences by divergent HIV-1 non-B subtypes compared to HIV-1 subtype B that largely infects the high-income countries (just 10% of 37 million infected). This review compares the inhibition and resistance of diverse HIV-1 subtypes and strains to the various approved drugs as well as novel inhibitors in clinical trials. Initial sequence variations and differences in replicative fitness between HIV-1 subtypes pushes strains through different fitness landscapes to escape from drug selective pressure. The discussions here provide insight to patient care givers and policy makers on how best to use currently approved ART options and reduce the emergence of drug resistance in ∼33 million individuals infected with HIV-1 subtype A, C, D, G, and recombinants forms. Unfortunately, over 98% of the literature on cART resistance relates to HIV-1 subtype B.

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来源期刊
FEMS microbiology reviews
FEMS microbiology reviews 生物-微生物学
CiteScore
17.50
自引率
0.90%
发文量
45
审稿时长
6-12 weeks
期刊介绍: Title: FEMS Microbiology Reviews Journal Focus: Publishes reviews covering all aspects of microbiology not recently surveyed Reviews topics of current interest Provides comprehensive, critical, and authoritative coverage Offers new perspectives and critical, detailed discussions of significant trends May contain speculative and selective elements Aimed at both specialists and general readers Reviews should be framed within the context of general microbiology and biology Submission Criteria: Manuscripts should not be unevaluated compilations of literature Lectures delivered at symposia must review the related field to be acceptable
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